-height: 5’ 10
-waist: 32 inches
-weight: 165 lbs (about 15% bf)
-describe body and facial hair: light build. moderately hairy, beard grows fairly fast and thick.
-describe where you carry fat and how changed: lower abs and love handles mainly. Hasn’t changed and difficult to lose.
-health conditions: Gluten Sesitive (likely Celiac), Epididymitis about 4 months ago, Vasectomy 3 years ago.
-Rx and OTC drugs, any hair loss drugs or prostate drugs ever: No hair loss or prostate drugs. About 10 grams of OTC hydrocortisone cream (1% so about 10mg cortisone) topically in the AM.
-describe diet: pretty good, gluten-free with limited processed foods or sugars. About 3,000-3,500 cals per day. I was low-carb Paleo for a while before. Tried intermittent fasting (16 hr fast each day) and felt good but stopped because it was harder for me to hit my target caloric intake.
-describe training: 2-3x per week when feeling good. Lately, don’t have the energy to go to the gym.
-testes ache, ever, with a fever?: Yes, low grade fever with epididymitis. Cleared up with anti-biotics. Recently had minor pain in the same testicle but it went away the next day.
-how have morning wood and nocturnal erections changed: infrequent and weak.
-Fatigue: some days it is exhausting to do anything. Most days I feel tired (but manageable) with periods of more intense fatigue (usually around 6pm).
-Difficult to get out of bed in the morning. Don’t feel rested when I wake up.
-Libido has dropped off a lot but no ED or performance issues. Just not interested very much at all anymore.
-Anxiety: can pop up without reason. Lately it seems to be accompanied by constricted/dry nasal passages - feels like I not getting enough air.
- Difficulty handling stress: A minor argument can be overwhelming and can ruin me for a couple of days. Major stress tends to focus me and I’m able to perform but once things calm down I crash. This has been confusing because I will feel better when under acute stress but worse when life is good and I’m trying to rest/recover.
- Brain fog: lately it has been minor, worse in the past.
- Hard time putting on muscle mass, and equally hard time losing belly fat.
- Low average body temp (<98.0) and waking temp (<97.0)
- Mild depression: mainly due to poor health and not getting better, not being able to workout.
- Social withdraw. Don’t want to talk to people sometimes, even good friends.
- Frequent illness (colds) that tend to linger for up to a month
- Don’t feel hungry when I should. I usually have to force myself to eat a meal, especially breakfast. Will feel really hungry after a big dinner.
- Prickly, tingly feeling in my shoulders, arms or legs at times. Moves around but usually balanced (left and right side feel the same). Not numbness. Kind of like really light electricity.
Gaia herbs Adrenal Support (2 caps 2x per day with meals)
Multivitamin (Vitamin Code Men)
Vit B stress complex
Vit D 6000 iu (I wasn’t very consistent with this leading up to the blood test - probably 2x per week)
Vit C 1000mg
Fish Oil - about 2g
I have been lifting off an on over the last 10 years with little to no progress. Two years ago I started to really focus on my training and get serious about my diet in an attempt to put on some weight. I made a little progress but it stalled - couldn’t gain weight and wasn’t leaning out either. Around that same time, I started having increased feelings of anxiety and frequent illnesses that kept me out of the gym for long periods of time.
Saw a Functional Medicine Dr. and was diagnosed with Adrenal Fatigue (via 24hr saliva test), hookworm, low Vit-D, and Gluten Sensitvity. Treated the hookworm, supplemented for Adrenal Fatigue (sublingual liquorice root, DHEA, and Pregneolone) and Vit-D, tried to reduce stress and improve sleep. Went 100% gluten free and did an elimination diet to rule out any other food reactions. Lost weight and leaned out but lost a lot of strength. Felt a little better, returned to the gym and built my strength back up. Each time I started to make progress, injury or illness would kill my gains.
In October, I went through a stressful time and wasn’t recovering well. Fatigue started to get much worse around December, to the point that I began wondering if I had Addisons. Adrenal Supplements and rest were not helping at all so I resorted to OTC Cortisone cream to help prop up my adrenals. After a couple weeks I started to feel better, back in the gym taking it easy, but after 3 weeks it all went downhill again. Fatigue came back even with Cortisone. Found a HRT Dr. that was listed as In-Network by my insurance and made and appt. Turns out he doesn’t take insurance anymore but I decided to do the blood work meet with at least once.
At this point I don’t care about gains in the gym. I just want to feel better.
Dr. ordered a bunch of test that may or may not be relevant, so I’m only going to list the highlights here and I’ll include the full report in a later post. Unfortunately, he did not include LH, FSH, Prolactin, or rT3. Also, I discontinued the topical cortisone four days prior to the test, as I didn’t want my adrenal labs to be artificially propped up.
Lab Results from 2/8/12 @ 8:15am (partial)
WBC: 4.33 K/uL (4.5-11.5)
MCH: 31.4 pg (27-31)
CO2: 37 mEq/L (21-31)
BUN: 22 mg/dL (7.0-25.0)
Creatinine: 1.0 mg/dL (0.7-1.2)
BUN/Creatinine Ratio: 22.0 (10.0-20.0)
Vitamin B-12: 890 pg/ml (211-911)
Vitamin D,25 Hydroxy: 36 ng/ml (>30)
Cortisol-AM: 20 ug/dL (8-23)
T3 Free: 3.00 pg/mL (2.3-4.2)
T3 Uptake: 34.7% (22.5-37.0)
T4 Free: 1.48 ng/dL (0.89-1.76)
TSH (ultrasensitive): 1.94 uIU/ml (0.34-4.00)
Thyroglobulin Autoabs: <20.0 IU/mL (<40)
Thyroid Peroxidase Autoabs: <10.0 IU/mL (<35)
IGF-1: 389.0 ng/mL (109-284)
Testosterone Total: 348.0 ng/dL (20-49 years: 160-726)
SHBG: 31.3 nmol/L (13-71)
Free Testosterone: 67 pg/ml (47-244)
Albumin: 4.9 g/dL (3.5-4.8)
DHEA-S: 265.0 ug/dL (80.0-560.0)
Estradiol: 20 pg/mL (0-39.8)
Progesterone: 0.49 ng/mL (0.28-1.22)
5-a-Dihydrotestosterone: 220.0 pg/ml (106.0-719.0)
To be honest, I don’t know how to feel about these results. Cortisol looks good, and Thyroid labs aren’t as bad as I expected based on my symptoms and body temps. Test is low but IGF-1 is high (WTF?). And I don’t know what the deal is with my WBC and CO2. I was hoping the labs would clarify things for me but now I’m even more confused. Am I missing something?
I meet with the Dr. tomorrow and would really appreciate any feedback you guys might have. Any thing else I should be considering before starting treatment?